Olecranon Osteotomy With Tension Band Wire Repair

Purpose: The purpose of this video is to demonstrate the surgical technique of olecranon osteotomy with tension band wire repair. Methods: A patient with a comminuted, intra-articular distal humerus fracture requiring ORIF is presented in this video demonstration of the surgical technique of an olecranon osteotomy. The olecranon osteotomy is an established technique for approaching the distal humerus for surgical repair of fracture. In the video, the patient is positioned laterally allowing a dorsal incision. The ulnar nerve is identified and protected. A chevron osteotomy, apex distally based, is created in the proximal ulna using osteotomes, centering the osteotomy within the sulcus of the proximal ulna. Once the osteotomy has been completed, the proximal ulna is reflected proximally to allow access to the distal humerus. The osteotomy is repaired using a tension band wire technique. The 2 longitudinal K-wires (0.062 inches) engage the volar cortex of the ulna and the tips of the pins are buried beneath the triceps tendon. A figure 8, 18-gauge cerclage wire is twisted to compress the osteotomy site at the end of the procedure to promote stability and healing. Results: The video is 10 minutes, 30 seconds duration in time and 2,048,409,000 bytes in size. Conclusions: Various techniques of olecranon osteotomy have been described. The principles of a well-centered osteotomy and a stable repair are essential to this technique. This is demonstrated in the video of an olecranon osteotomy using osteotomes and a tension band repair.